The Preschool Inside a Nursing Home

EDUCATION

For the elderly residents, interacting with the kids is a jolt back to the world of the living.

TIFFANY R. JANSEN
JAN 20, 2016

Giggles and the pitter patter of little feet echo through the halls of Providence Mount St. Vincent in Seattle—not exactly the sounds you’d expect to hear in a living-care community for older adults. Then again, “the Mount,” as it’s known, isn’t your typical nursing home.

Five days a week, residents and staff share the 300,000 square-foot facility with up to 125 children, ages zero to five. These children and their teachers make up the Mount’s Intergenerational Learning Center (ILC), a licensed nonprofit child-care center and preschool established on the Mount’s premises in 1991.

The program was designed to counterbalance the loneliness and boredom that so often characterize life in a nursing facility. These challenges can be particularly evident in homes like the Mount, where the average age is 92 and residents are largely fragile, non-ambulatory, and in need of significant assistance. “We wanted a living, vibrant community; to make sure that this was a place where people came to live, not die,” says Charlene Boyd, an administrator at the center. Bringing children in was a natural solution.

Numerous studies have linked social interaction with decreased loneliness, delayed mental decline, lower blood pressure, and reduced risk of disease and death in elders. Socializing across generations has also been shown to increase the amount of smiling and conversation among older adults, according to one Japanese study from 2013.

While it’s unclear what kind of impact such social interaction has on children, research suggests it may come with a variety of benefits for them as well. For example, kids who have early contact with older people are less likely to view them as incompetent—and simply exposing children to positive depictions of elders makes them less likely to exhibit ageism. These intergenerational interactions also enhance children’s social and personal development. And, as many of the parents whose children attend the ILC will attest, the kids are prone to feel more comfortable around those with disabilities and impairments of all kinds than their peers who lack such experiences.

Integrating preschools and nursing homes isn’t an established trend, and there appears to be no real tally of how many are in existence. But judging by the viral nature of videos and articles depicting these programs on social media, it’s a movement many are eager to embrace. In 1976, a Japanese man named Shimada Masaharu combined the nursery school and home for the aged in Tokyo’s Edogawa municipality under one roof. By 1998, Kotoen was one of 16 such joint facilities, according to the Tokyo Ministry for Health, Labour, and Welfare. The idea trickled over to North America around the same time, and today there are intergenerational centers for elders and young children across Japan, Canada, and the United States.

Humans are, and have always been, an intergenerational species. Still, to keep up with the demands of the culture and society of today, the responsibilities of child and elder care have, out of necessity, been outsourced to professionals. “We live in a culture, time, and place where creative people have to use creative means to accomplish something that was always the most ordinary, customary thing in the human experience: older people and younger people sharing their lives,” says Bill Thomas, a doctor and international authority on geriatric medicine and eldercare.

At the Mount, there are plenty of opportunities for intergenerational engagement between residents and the children. Six times a week, teachers take their groups to the residential floors to visit the elders for anywhere from 20 minutes for the infants to 60 minutes for the older children. Residents are welcome to observe in the classrooms, and structured activities for the children and residents to participate in together are scheduled daily. Because they share the same building, there are opportunities for spontaneous engagement, too—when inclement weather strikes, and the children must make do with the halls, lobby, and vacant rooms as their playground, for example. Or when an area musician comes around to play tunes for the children to sing and dance to along with the elders.

Of the families that send their children to the Mount, roughly 10 percent are employees and a large majority are from the West Seattle area. Thanks to support from the Mount and its parent organization, Providence Health & Services, the center is able to offer tuition assistance and a 20 percent discount to staff members. Parents are interested in the program largely due to its reputation. The teachers, who are required to have at least 15 college-credit hours in early childhood education and complete an annual senior-care training, are cited as the biggest draw.

“A huge foundational piece of what we do here is teach the children how to solve their own problems,” says Marie Hoover, the director of the Intergenerational Learning Center. “We spend a lot of time with phrases like ‘I see you both want the same ball. What are your ideas for how to solve this?’ Then we work with the kids until they either come up with their own ideas or the teacher gives them some suggestions for working it out. We get a lot of positive feedback about that.” It isn’t until parents tour the facility that they take notice of the intergenerational component, according to Hoover, which only serves to get them more excited about the program. Last I checked, there were more than 400 families on the ILC’s waitlist.

Meanwhile, for the residents, the intergenerational engagement is a jolt back to the world of the living. In fact, it was this dynamic that caught the attention of the Seattle-based filmmaker Evan Briggs in early 2012. “For a long time I had been wanting to make a film that explored the issue of aging in America,” she says. “When I found out about this retirement home with a preschool inside of it, I felt that was a really beautiful and poignant way to frame some of the issues and themes I wanted to address.” Present Perfect, the resulting documentary due out in 2017, explores what happens when human connection across generations is encouraged and facilitated.

In a clip from Briggs’s documentary, a resident in a wheelchair with drooping jowls and stooped shoulders leans in close to a small boy to ask his name. “Max,” the boy replies. “Oh, Mack,” the gentleman says, leaning back in his chair. With admirable patience, particularly for one so small, the child states his name repeatedly, with increasing volume and ever more precise articulation, as the resident continues to get it wrong.

EVAN BRIGGS
Another resident with advanced Alzheimer’s whose speech was incomprehensible garble was able to speak in complete, fluid, and appropriate sentences the moment she was wheeled into the baby room. “You could immediately see that she had accessed some part of her brain that had raised several kids,” Hoover says.

During interviews with staff members at the Mount, I asked how the children at the ILC tend to deal with the death of a resident. I was told that the children might notice a resident was missing and ask a few questions but typically demonstrate little significant emotional attachment.

For Thomas, the geriatrician, this raises questions about whether truly meaningful relationships are being developed through the ILC. “Say the kids are coming in to see the elders,” he posits. “If one of the kids calls out the name of an elder and runs toward that elder with their arms outstretched, that’s the next step.” While Thomas applauds the efforts of the Mount and other institutions experimenting with these types of programs, he says more opportunities for meaningful engagement and reciprocity are needed to reach that next level.
The institutionalization and bureaucracy of care homes tend to limit their ability to create such opportunities, according to Matt Kaplan, a professor of intergenerational programs and aging at Pennsylvania State University. “In nursing homes, policies tend to be rigid,” he explains. “How you spend your time, where you spend it—it’s all being regulated.” In other words, rather than forming organically, any relationships that develop do so within the framework set by the professionals.

And ultimately, just like Cinderella’s enchanted transformation, the magic may only last for a fixed amount of time. “As beautiful as [a program like this is], they march those kids right out of there at [6 o’clock], and five minutes later, that elder who had just been brought to life is sitting slumped over in a chair by a nurse’s station,” Thomas says. “And that’s the sad part of the story.”

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Published by caring for our generations

1 thought on “The Preschool Inside a Nursing Home”

My parents worked at a nursing home when I was little, and they’d take me to work with them because they couldn’t get other childcare. They said that my grades went up at the time because one of the residents there had been a teacher, and she became more lively from working with me, so I can say from experience that indeed, relationships across generations can benefit both younger and older people.